Brain/diagnostic imaging* ; Head

Objective:To explore the differences in imaging characteristics and risk factors for mortality between the young and middle-aged and elderly patients with aortic dissection.Methods:The data from 1 220 patients with aortic dissection from January 2007 to December 2015 were successively collected. They were divided into young and middle-aged and elderly groups according to their ages. The basic information, computer comography angiography and echocardiogram results, hospital admissions and surgical details were collected and compared between the two groups using single variable regression analysis.Results:The ratio of female patients in the middle-aged and elderly group (>45 years old) was significantly higher than that of the young group (≤45 years old) (24.9% vs 18.7%, P=0.014), the ratio of hypertension patients was also significantly higher than that in the young group (77.5% vs 68.1%, P<0.001). Echocardiographic parameters showed that the prevalences of left ventricular enlargement (39.9% vs 26.9%) and left ventricular dysfunction (22.3% vs 14.1%) in the young group were significantly higher than in the middle-aged and elderly group (all P<0.001). The prevalences of ascending aorta dilation [(43.04±9.12)mm vs (41.69±10.99)mm] and thrombosis (39.1% vs 28.5%) were higher ( P<0.05). Although there was no statistically significant difference in mortality within 60 days after admission between the two groups (12.0% vs 15.1%, P=0.164), univariate regression analysis showed that aortic branch involvement was the main independent risk factor for mortality in young patients. Left ventricular remodeling (left atrial enlargement, ascending aortic dilation, aortic regurgitation) and decreased heart function were the main independent risk factors for death in the elderly patients. Conclusions:The mortality rate of young and middle-aged and elderly patients with aortic dissection are comparable, but the influencing factors are different. Screening out the relevant risk factors that affect the survival rate of the two groups, and conducting targeted prevention and intervention on them areof great significance to improve the survival rate of patients.

Objective:To observe the effect of breastfeeding on the incidence of retinopathy of prematurity (ROP).Methods:A retrospective clinical study. From June 2017 to December 2019, 1256 eyes of 628 premature infants who were born in Ningbo Women and Children's Hospital and were screened for ROP were included in the study. Among them, there were in 325 males (650 eyes) and 303 females (606 eyes). According to the feeding situation, premature infants were divided into breastfeeding (research) group and formula feeding (control) group, with 390 cases of 780 eyes and 238 cases of 476 eyes, respectively. The changes in the retina of the fundus of the two groups of premature infants during the observation period were compared. The qualitative data comparison between groups was performed by the χ2 test; the quantitative data comparison was performed by the two independent sample t test. Results:The sex ratio of premature infants in the study group and control group ( χ2=0.217), birth weight ( t=0.728), gestational age at birth ( t=0.351), Apgar score at birth ( t=0.816), oxygen inhalation time ( t=0.427), were compared with the length of stay in the neonatal intensive care unit ( t=1.580), the difference was not statistically significant ( P>0.05). Among the 390 cases in the study group, 108 cases (27.7%, 108/390) and 282 cases (72.3%, 282/390) were with or without ROP, respectively; in the 238 cases in the control group, 86 (36.1%, 86/238) were with ROP, 152 (63.9%, 152/238) cases were without ROP. There was a statistically significant difference in the incidence of ROP between the two groups ( χ2=4.934, P=0.026). Among the 108 cases of ROP in the study group, 50 (12.8%, 50/108), 35 (9.0%, 35/108), 23 (5.9%, 23/108) cases were in stage 1, 2 and 3, respectively. Among the 86 ROP cases in the control group, stages 1, 2 and 3 were 25 (10.5%, 25/86), 40 (16.8%, 40/86), and 21 (8.8%, 21/86), respectively. In the comparison of ROP staging between the two groups, the difference in stage 1 was not statistically significant ( χ2=0.754, P>0.05), and the difference in stage 2 and above was statistically significant ( χ2=11.400, P<0.05). Conclusion:Breastfeeding may reduce the incidence and severity of ROP.

Objective:To explore the morphological parameters of tricuspid in patients with moderate or above functional tricuspid regurgitation (FTR ) by real-time three-dimensional (3D) transthoracic echocardiography.Methods:A total of 31 moderate or above FTR(FTR group) and 36 healthy adults(control group) were included in the study from May to July 2020 in the First Affiliated Hospital of Air Force Medical University (Xijing Hospital). Two-dimensional (2D) and 3D echoardiography were performed on both FTR group and control group. The 2D parameters included tricuspid regurgitation (TR), transverse diameter of right atrium/ ventricle, transverse diameter of tricuspid annulus(TVD), left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS). The tricuspid 3D parameters were analyzed by TomTec software, including annular parameters[annular anterior-posterior diameter (AP), annular left-right diameter (AL-PM), sphericity index (SI=AP/AL-PM), non-planar angle (NPA), annulus circumference (AC), annulus area (AA), annulus height (AH)], leaflet parameters[tenting volume(TV), tenting area(TA), tenting heigh(TH), commissural diameter(CD)], and dynamic parameters[annular displacement max(ADmax), annulus area fraction(AAF)].Results:Compared with the control group, AP, AL-PM, SI, AC, AA, TV, TA parameters of FTR group were larger, ADmax was smaller (all P<0.05). Multiple linear regression model was used to evaluate the effects of RA, RV, AP, AL-PM, SI, TV, TA on FTR, and the results showed that FTR was associated with TV and TA( t=4.253, -2.14; all P<0.05). Conclusions:RT-3DE can be used to assess the morphological parameters of tricuspid valve with moderate or above FTR patients effectively. TV and TA are the two most important factors for moderate or above FTR.

Objective To retrieve,assess and summarize the best evidence on breast milk expression of premature infants' mothers in maternal separation so as to provide high-quality evidence for medical staff to carry out breast feeding guide. Methods Guidelines,systematic reviews,recommended practices and evidence summaries were retrieved in the UpToDate,WHO,Academy of Breastfeeding Medicine(ABM), Cochrane Library,Joanna Briggs Institute Library,Registered Nurses' Association of Ontario(RNAO), National Guideline Clearinghouse(NGC),PubMed,Embase,Chinese Biological Medicine,Chinese National Knowledge Infrastructure,WanFang data,VIP and the evidence-based nursing database of Fudan University from January 2008 to December 2018. Results A total of 7 literatures were included,two guidelines,one clinical decision,two systematic reviews and two evidence summaries. A total of 19 evidences were gathered in 7 aspects,such as training for medical staff,parents' education,selection of breast pump,preparation before expression,operational skills of breast expression,measures for increasing lactation and expression effects monitor. Conclusions Clinical medical staff should lay down the individualized nursing measures for maternal women to ensure breast milk collected as soon as possible,gain enough breast milk and fill the bill of growth and development of premature infants.

Objective To explore the detection rate ,types ,accompanying abnormalities and prognosis of fetal congenital heart disease(CHD) in a single center in northwest China ,in order to set up a foundation for further studying the epidemiological characteristics of fetal CHD and integrated management of fetal CHD in the prenatal and postnatal . Methods A total of 2725 CHD in 45015 fetus diagnosed by fetal echocardiography were enrolled . The fetal CHD detection rate and the composition ratio were calculated . Follow-up results between the simple CHD and complex CHD were analyzed . Results The detection rate of fetal CHD in our center was up to 6 .1％ . There were 1589 cases of complex CHD ,accounting for 58 .3％ in all the fetal CHD ,of which the most common type was single ventricle ,followed by tetralogy of Fallot , atrioventricular septal defect and double outlet right ventricle ;Simple CHD 1136 cases ,accounting for 41 .7％ in all the fetal CHD ,the most common type was ventricular septal defect . The number of abortion cases ,intrauterine and postnatal natural deaths of fetal CHD accounted for 60 .3％ ( 1357/2251) of the total follow-up ,of which complex CHD and chromosomal abnormalities accounting for the majority . 68 cases of CHD underwent surgical treatment after birth ,of which complex CHD were predominant . 37 cases of simple CHD spontaneous closure and 27 cases of simple CHD genetic test results were abnormal . Conclusions The detection rate of CHD in this group is relatively high ,which is related to the prenatal diagnosis consultation center . Fetal complex CHD is more common while the prognosis is worse than simple CHD . Prenatal and postnatal integrated management of fetal CHD has important clinical value in early treatment of complex CHD .

Objective To observe the clinical efficacy of needle warming therapy plus pelvic floor muscle training in treating post-stroke neurogenic bladder.Method A total of 124 patients with post-stroke neurogenic bladder were divided into a treatment group and a control group by random number table, 62 cases in each group. The treatment group was intervened by acupuncture, moxibustion plus pelvic floor muscle training; the control group was intervened by Chinese patent drugs. The intervention was conducted with 2 weeks as a treatment course, for 3 treatment courses in total. The daily voiding frequency test and maximum cystometric capacity (MCC) in the two groups were measured before and after the intervention, and the clinical efficacies were compared between the two groups.Result Each item of the daily voiding frequency test in the two groups was significantly changed after the treatment (P<0.01). Each item of the daily voiding frequency test in the treatment group was significantly different from that in the control group after the treatment (P<0.01). The MCC was significantly changed after the intervention in both groups (P<0.01). The MCC in the treatment group was significantly different from that in the control group after the treatment (P<0.01). The recovery rate and total effective rate were respectively 35.5% and 96.8% in the treatment group versus 19.4% and 77.4% in the control group. There were significant differences in comparing the total effective rate (P<0.01) and the recovery rate between the two groups (P<0.05).Conclusion Needle warming therapy plus pelvic floor muscletraining can produce a significant therapeutic efficacy in treating post-stroke neurogenic bladder, and the therapeutic efficacy is obviously better than that of medication.

Objective To explore the expression of peripheral T cell subgroup (CD3+,CD4+,CD8+,CD4+CD25 high regulatory T cells) and the level and significance of serum cytokines in patients with silicosis.Methods One hundred and six cases patients with silicosis were collected in the Fifth People''s Hospital of Suzhou as study subjects and 56 healthy subjects as control group.Flow cytometry was used to detect the peripheral CD3+,CD4+,CD8+ and CD4+CD25 high regulatory T cells (Treg) of the patients and the control group,while chemiluminescence immunoassay was utilized to measure the peripheral serum soluble interleukin-2 receptor (sIL-2R),interleukin 6 (IL-6),interleukin 8 (IL-8) and tumor necrosis factor α (TNF-α).Results (1) The percentages of peripheral CD3+,CD4+ and CD8+ in the silicosis group were all lower than those in the control group (t=3.755,3.828,2.347,P<0.05);the percentage of Treg cells was higher in the silicosis group than in the control group,the difference was statistically significant (t=-8.345,P<0.05).Compared with the control group,based on the one-way analysis of variance,the differences in CD3+,CD4+,CD8+ and CD4+CD25 high cells were all statistically significant (F=5.620,8.007,26.71,P<0.05);in the silicosis group,the percentage of CD4+ T cells was lower in stage III than in stage I (t=3.424,P<0.05);compared with the control group,the percentages of Treg cells in the silicosis group were lower in all stages (t=-7.934,-9.445,-5.096,P<0.05).(2) The levels of peripheral sIL-2R,IL-6,IL-8 and TNF-α in the silicosis group were higher than those in the control group,the difference were statistically significant(t=-6.952,-4.506,-2.551,-5.670,P<0.05);compared with the control group,based on the one-way analysis of variance,the differences in sIL-2R,IL-6 and TNF-α in all stages were statistically significant (F=11.03,11.31,13.22,P<0.0001);the sIL-2R was higher in patients with stage III silicosis than that of stage I (t=-2.882,P<0.05);IL-6 was significantly higher in stage II and III silicosis group than that of stage I group (t=-3.022,-2.632,P<0.05),and TNF-α was higher in patients with stage II silicosis than patients with stage I silicosis (t=-2.322,P<0.05).(3) The level of peripheral Treg cells was negatively correlated with the percentages of CD3+ and CD8+ cells in patients with silicosis (r=-0.357,-0.508,P<0.05);sIL-R2 was positively correlated with IL-6,IL-8 and TNF-α,respectively (r=0.483,0.199,0.392,P<0.05);TNF-α was positively correlated with IL-6 and IL-8,respectively (r=0.338,0.338,P<0.05).Conclusion Patients with silicosis have abnormal expression in peripheral T cell subgroups,significantly increased Treg cell and dysfunctional cytokines,which may be associated with the pathogenesis of silicosis,the detection of these indicators may have significance of diagnosis,staging,disease monitoring and prognosis of the diseases.

Objective To investigate protective effect of tribulus terrestris L (TTL) on photoreceptor in the model of light-induced retinal degeneration.Methods BALB/c mice were exposed to bright light at the intensity of 10 000 lux for 30 minutes to establish the retinal light damage models.The BALB/c mice were divided into normal control group,model group and treatment group,6 cases in each group.TTL decoction was intraperitoneally administered to mice 30 minutes prior to illumination in the treatment group.Saline vehicle was administered in the normal control group and model group.Photoreceptor protection of TTL was assessed by optical coherence tomography (OCT) at 3 hours and 7 days after illumination.Gross histology and immunohistochemistry approaches were also taken to examine the retinal protection conferred by TTL at 7 days after bright light exposure.Results Compared to normal retinal morphology in the normal control group,prominent photoreceptor loss and diminished rod and cone photoreceptors evidenced by attenuated retinal expression of rhodopsin and M-opsin were observed in the model group.In contrast,TTL treatment resulted in significant protection against bright light-induced photoreceptor degeneration and remarkable preservation of rod and cone photoreceptor cells.The outer retinal nuclear layer in the model group was thinner than that in the normal control group (P ＜ 0.05),but the treatment group was thicker than the model group (P ＜ 0.05).Conclusion Bright light induces obviously degeneration in photoreceptors in BALB/c mice.Moreover,TTL is shown for the first to significantly protect the photoreceptors from bright light-induced degeneration.

Objective To describe the expressions of programmed death-1 (PD-1) and its ligand PD-L1 on the surface of peripheral blood lymphocytes in patients with tuberculosis.Methods A total of 77 cases of pulmonary tuberculosis were recruited,of which 27 were single infection,41 were coincident with bacterial or fungal infection and 9 patients with diabetes mellitus.Twenty-nine healthy donors were also enrolled as control group.The expressions of PD-1/PD-L1 on the peripheral blood lymphocytes and mononuclear cells were detected using immunostaining and flow cytometry.Collected data were analyzed with t-test statistics.Results Among the three groups of tuberculosis including pulmonary tuberculosis,pulmonary tuberculosis coincident with infection and pulmonary tuberculosis with diabetes mellitus,the percentages of CD4+ CD25+ T cells as well as CD4+ CD25high T cell subsets were both significantly higher than those in healthy controls (t=4.892,4.635,4.974,5.407,4.660,5.279,all P＜0.01).The expression of PD-1 was up regulated on the surface of CD8+ T cells in the groups of tuberculosis as compared with the control group (t=6.392,8.249,7.072,all P＜0.01).The proportions of PD-L1 expressed on the monocytes in each group were (42.51 ± 7.54) ％,(49.42± 6.29) ％ and (48.46 ± 14.58)％,respectively.The difference was significant in contrast to the control group,which was (17.91 ±3.03)％ (t=5.168,6.854,5.665,all P＜0.01).PD-L1 expression was also up-regulated on B cells in each group and much higher than that of the control group (51.51±7.32)％,(50.85±7.09)％,(55.66±14.29)％ vs (40.11±4.25)％ (t=2.562,2.046,2.766,all P＜0.05).Conclusion PD-1/ PD-L1 co-inhibitory pathway could be closely related to the development of tuberculosis and its complications,which is involved in the attenuation of anti-tuberculosis and anti infection immune responses.